The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur.
This finding is associated with which congenital heart defect?
Pulmonary stenosis
Patent ductus arteriosus
Ventricular septal defect
Coarctation of the aorta
The Correct Answer is B
This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.
Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.
Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.
Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
choice A. Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide.

Surfactant is a substance that coats the inner surface of the alveoli, the tiny air sacs in the lungs.
It reduces the surface tension of the alveoli and prevents them from collapsing during exhalation.
Premature infants often lack enough surfactant, which leads to respiratory distress syndrome (RDS).
Artificial surfactant is given to these infants to help them breathe more easily. Choice B is wrong because surfactant has nothing to do with sedation.
Sedation is a state of reduced consciousness induced by drugs. Surfactant does not affect the level of consciousness of the infant.
Choice C is wrong because surfactant is not used to reduce episodes of periodic apnea.
Periodic apnea is a condition where the infant stops breathing for a short time, usually due to immature brainstem function.
Surfactant does not affect the brainstem or the control of breathing.
Choice D is wrong because surfactant is not used to fight a possible respiratory tract infection. Surfactant does not have any antibacterial or antiviral properties.
Surfactant is used to treat RDS, which is caused by a lack of surfactant, not by an infection.
Correct Answer is C
Explanation
Placing eye shields over the newborn’s closed eyes. This is because phototherapy can cause eye damage and irritation to the newborn, so eye protection is essential.
Choice A is wrong because oil-based lotion can increase the absorption of heat and cause burns to the newborn’s skin.
Choice B is wrong because limiting the newborn’s intake of milk can cause dehydration and increase the risk of hyperbilirubinemia.
Choice D is wrong because changing the newborn’s position every 4 hours is not frequent enough to prevent pressure ulcers and ensure even exposure to the light.
Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL for term infants and 3 to 14 mg/dL for preterm infants. Phototherapy is usually indicated when the bilirubin level exceeds 15 mg/dL for term infants and 10 mg/dL for preterm infants.
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